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Epidemics: Conference on Infectious Disease Dynamics, Pacific Grove, California, December 1-3, 2008

Dr. Steven Cohen represents InForMID to attend the Epidemics: Conference on Infectious Disease Dynamics. He presents his work on the intergeneration transmission of influenza.

Abstract: During the influenza epidemics of 2007-08, the CDC recommended that all children age 6 months to 18 years receive influenza vaccination.  A growing body of evidence indicates that vaccinating children against influenza not only provides a direct benefit to children by reducing morbidity and mortality in children themselves, vaccination may also impart indirect benefits to the rest of the population by curtailing the transmission of influenza from children to other subpopulations, namely the elderly.  The purpose of this study is to determine if immunizing children against influenza is an effective strategy to reduce influenza-related morbidity in the elderly, and if greater contact between grandparents and grandchildren, as assessed through grandparental caregiving, increases influenza burden in the elderly.  To evaluate these hypotheses, we abstracted 14 million pneumonia and influenza hospitalizations (ICD-9CM 480-487) from the Centers for Medicare and Medicaid Services hospitalization claims database from 1991 through 2003, categorized each by influenza season (July-June) to estimate annual rates of disease, and compared these to vaccination coverage rates in children and grandparental caregiving levels from the US Census for 2,738 US counties.  Vaccination coverage in children was inversely related to influenza-associated hospitalization rates in the elderly, particularly in the oldest elderly.  Caregiving for grandchildren, however, was associated with increased influenza-associated hospitalization rates in the elderly, especially in the younger elderly population.  These results underscore the potential for influenza and pneumonia to be readily transmitted from children to the older population.  Targeting children for influenza vaccination, as well as grandparents who provide care for their grandchildren may be an effective strategy to impede intergenerational influenza transmission from children to elderly.